Grommet insertion is a procedure in which a tiny ear tube, known as a grommet, is inserted into the eardrum to treat a condition commonly known as glue ear. The medical name for glue ear is otitis media, and it is an infection of the middle ear, causing it to fill with thick fluid. After removing this fluid, grommet insertion may be carried out, and the small tube allows air into the middle ear, equalizing the pressure between the middle ear and the outer ear passage. Although the exact mechanism is not understood, this helps prevent further infections occurring. This can be particularly important for children with glue ear, because recurring infections might otherwise interfere with their hearing and cause speech and learning problems.
A grommet is made of plastic and may also be referred to as a myringotomy tube, tympanostomy tube or pressure equalization tube (PE tube). Grommet insertion takes place while the patient is unconscious, under the influence of a general anesthetic. The surgeon makes a tiny cut in the eardrum. All of the operation is carried out through the ear passage, so that there is no need to open up any of the skull or to cut into the external ear. Once the cut in the eardrum has been made, fluid can be sucked out of the middle ear.
Grommet insertion then takes place. The tube is carefully positioned inside the hole in the eardrum. A grommet is flared at each end, which helps keep it in place.
Ear drops may be added to the ear, and the ear canal is usually blocked up with a piece of cotton. It normally takes at least a couple of hours to recover from the anesthetic, but patients are usually able to go home the same day. A follow-up appointment usually takes place around two weeks after grommet insertion to check that all is well.
Normally, hearing improves immediately after grommet insertion and there are no problems apart from a little ear discharge initially, but sometimes complications can occur. If ear discharge becomes foul-smelling or yellow, this can indicate an infection, which could require a course of antibiotics. Grommets usually stay in the ears for anything from six to 18 months before dropping out by themselves. Typically, the hole in the eardrum then heals but, if not, a further operation may be necessary to close it. If grommets remain in the ears for two years or more, doctors may decide to remove them.